Teucrium francoi M. Seq., Capelo, J.C. Costa & R. Jardim, a new species of Teicrium gr. scorodonia (Lamiaceae) from Madeira

The species formerly recognized as Teucrium scorodonia in Madeira is here described as new: Teucrium francoi M. Seq., Capelo, J.C. Costa & R. Jardim. Morphologically close to species of Teucrium gr. scorodonia [T. scorodonia L., T. pseudoscorodonia Desf., T. siculum (Raf.) Guss. and T. kotschyanum Poech], it exhibits, nonetheless, some distinct diagnostic characters. The indumentum density and type of hairs of T. francoi are clearly distinct from those of related species, as are the shape and dimensions of the leaves and bracts, calyx, and corolla, which are all taken as taxonomically significant diagnostic features. A diagnosis and a distribution map are presented for this new species. Morphology, ecology, biogeography, and conservation issues are discussed. Teucrium francoi, which is an endemic from Madeira (Portugal), is to be found mostly in the scope of the association Teucrio francoi– Origanetum virentis J.C. Costa, Capelo, Jardim, Sequeira, Lousã & Rivas-Martínez, but also occurs in somewhat humid habitats, such as open stands of Rosa mandonii Déségl. associated with small stream

Comparative efficacy of indacaterol 150 μg and 300 μg versus fixed-dose combinations of formoterol + budesonide or salmeterol + fluticasone for the treatment of chronic obstructive pulmonary disease – a network meta-analysis

Objective: To compare efficacy of indacaterol to that of fixed-dose combination (FDC)-formoterol and budesonide (FOR/BUD) and FDC salmeterol and fluticasone (SAL/FP) for the treatment of chronic obstructive pulmonary disease (COPD) based on the available randomized clinical trials (RCTs).Methods: Fifteen placebo-controlled RCTs were included that evaluated: indacaterol 150 mu g (n = 5 studies), indacaterol 300 mu g (n = 4), FOR/BUD 9/160 mu g (n = 2), FOR/BUD 9/320 mu g (n = 3), SAL/FP 50/500 mu g (n = 5), and SAL/FP 50/250 mu g (n = 1). Outcomes of interest were trough forced expiratory volume in 1 second (FEV1), total scores for St. George's Respiratory Questionnaire (SGRQ), and transition dyspnea index (TDI). All trials were analyzed simultaneously using a Bayesian network meta-analysis and relative treatment effects between all regimens were obtained. Treatment-by-covariate interactions were included where possible to improve the similarity of the trials.Results: Indacaterol 150 mu g resulted in a higher change from baseline (CFB) in FEV1 at 12 weeks compared to FOR/BUD 9/160 mu g (difference in CFB 0.11 L [95% credible intervals: 0.08, 0.13]) and FOR/BUD 9/320 mu g (0.09 L [0.06, 0.11]) and was comparable to SAL/FP 50/250 mu g (0.02 L [-0.04, 0.08]) and SAL/FP 50/500 mu g (0.03 L [0.00, 0.06]). Similar results were observed for indacaterol 300 mu g at 12 weeks and indacaterol 150/300 mu g at 6 months. Indacaterol 150 mu g demonstrated comparable improvement in SGRQ total score at 6 months versus FOR/BUD (both doses), and SAL/FP 50/500 mu g (-2.16 point improvement [-4.96, 0.95]). Indacaterol 150 and 300 mu g demonstrated comparable TDI scores versus SAL/FP 50/250 mu g (0.21 points (-0.57, 0.99); 0.39 [-0.39, 1.17], respectively) and SAL/FP 50/500 mu g at 6 months.Conclusion: Indacaterol monotherapy is expected to be at least as good as FOR/BUD (9/320 and 9/160 mu g) and comparable to SAL/FP (50/250 and 50/500 mu g) in terms of lung function. Indacaterol is also expected to be comparable to FOR/BUD (9/320 and 9/160 mu g) and SAL/FP 50/500 mu g in terms of health status and to SAL/FP (50/250 and 50/500 mu g) in terms of breathlessness.Novartis Pharma AGMapi Values, Boston, MA 02114 USANovartis Pharma AG, Hlth Econ & Outcomes Res, Basel, SwitzerlandNovartis Horsham Res Ctr, Horsham, W Sussex, EnglandUniversidade Federal de São Paulo, Div Resp, São Paulo, BrazilUniversidade Federal de São Paulo, Div Resp, São Paulo, BrazilWeb of Scienc

Reliability of the Brazilian version of the Functional Assessment of Cancer Therapy‐Lung (FACT‐L) and the FACT‐Lung Symptom Index (FLSI)

OBJECTIVES: The purpose of this study was to assess the reliability of the Brazilian version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) with the FACT-Lung Symptom Index (FLSI) questionnaire. INTRODUCTION: The assessment of quality of life in patients with lung cancer has become an important evaluative endpoint in current clinical trials. For lung cancer patients, one of the most common quality of life tools available is the FACT-L. Despite the amount of data available regarding this questionnaire, there are no data on its performance in Brazilian lung cancer patients. METHODS: The FACT-L with the FLSI questionnaire was prospectively administered to 30 consecutive, stable, lung cancer outpatients at baseline and at 2 weeks. RESULTS: The intraclass correlation coefficient between test and retest for the FACT-L ranged from 0.79 to 0.96 and for the FLSI was 0.87. There was no correlation between these questionnaire dimensions and clinical or functional parameters. CONCLUSIONS: The Brazilian version of the FACT-L with FLSI questionnaire is reliable and is quick and simple to apply. This instrument can now be used to properly evaluate the quality of life of Brazilian lung cancer patients

Distribution of alpha1 antitrypsin rare alleles in six countries: Results from the Progenika diagnostic network

Alpha1 antitrypsin deficiency; Diagnosis; Rare allelesDèficit d'alfa1 antitripsina; Diagnòstic; Al·lels rarsDéficit de alfa1 antitripsina; Diagnóstico; Alelos rarosBackground Knowledge of the frequency of rare SERPINA1 mutations could help in the management of alpha1 antitrypsin deficiency (AATD). The present study aims to assess the frequencies of rare and null alleles and their respiratory and hepatic pathogenicity. Methods This is a secondary analysis of a study that evaluated the viability of the Progenika diagnostic genotyping system in six different countries by analyzing 30,827 samples from cases of suspected AATD. Allele-specific genotyping was carried out with the Progenika A1AT Genotyping Test which analyses 14 mutations in buccal swabs or dried blood spots samples. SERPINA1 gene sequencing was performed for serum AAT-genotype discrepancies or by request of the clinician. Only cases with rare mutations were included in this analysis. Results There were 818 cases (2.6%) carrying a rare allele, excluding newly identified mutations. All were heterozygous except for 20 that were homozygous. The most frequent alleles were the M-like alleles, PI*Mmalton and PI*Mheerlen. Of the 14 mutations included in the Progenika panel, there were no cases detected of PI*Siiyama, PI*Q0granite falls and PI*Q0west. Other alleles not included in the 14-mutation panel and identified by gene sequencing included PI*Mwürzburg, PI*Zbristol, and PI*Zwrexham, and the null alleles PI*Q0porto, PI*Q0madrid, PI*Q0brescia, and PI*Q0kayseri. Conclusions The Progenika diagnostic network has allowed the identification of several rare alleles, some unexpected and not included in the initial diagnostic panel. This establishes a new perspective on the distribution of these alleles in different countries. These findings may help prioritize allele selection for routine testing and highlights the need for further research into their pathogenetic role

Update on and future perspectives for the diagnosis of alpha-1 antitrypsin deficiency in Brazil

Tècniques de genotipat; Deficiència d'alfa-1 antitripsinaTécnicas de genotipado; Deficiencia de alfa-1 antitripsinaGenotyping techniques; alpha-1 antitrypsin deficiencyAlpha-1 antitrypsin deficiency (AATD) is a rare genetic disorder caused by a mutation in the SERPINA1 gene, which encodes the protease inhibitor alpha-1 antitrypsin (AAT). Severe AATD predisposes individuals to COPD and liver disease. Early diagnosis is essential for implementing preventive measures and limiting the disease burden. Although national and international guidelines for the diagnosis and management of AATD have been available for 20 years, more than 85% of cases go undiagnosed and therefore untreated. In Brazil, reasons for the underdiagnosis of AATD include a lack of awareness of the condition among physicians, a racially diverse population, serum AAT levels being assessed in a limited number of individuals, and lack of convenient diagnostic tools. The diagnosis of AATD is based on laboratory test results. The standard diagnostic approach involves the assessment of serum AAT levels, followed by phenotyping, genotyping, gene sequencing, or combinations of those, to detect the specific mutation. Over the past 10 years, new techniques have been developed, offering a rapid, minimally invasive, reliable alternative to traditional testing methods. One such test available in Brazil is the A1AT Genotyping Test, which simultaneously analyzes the 14 most prevalent AATD mutations, using DNA extracted from a buccal swab or dried blood spot. Such advances may contribute to overcoming the problem of underdiagnosis in Brazil and elsewhere, as well as being likely to increase the rate detection of AATD and therefore mitigate the harmful effects of delayed diagnosis.This study received financial support from Grifols S.A., Barcelona, Spain

Highly N2-Selective Activated Carbon-Supported Pt-In Catalysts for the Reduction of Nitrites in Water

The catalytic reduction of nitrites over Pt-In catalysts supported on activated carbon has been studied in a semi-batch reactor, at room temperature and atmospheric pressure, and using hydrogen as the reducing agent. The influence of the indium content on the activity and selectivity was evaluated. Monometallic Pt catalysts are very active for nitrite reduction, but the addition of up to 1 wt% of indium significantly increases the nitrogen selectivity from 0 to 96%. The decrease in the accessible noble metal surface area reduces the amount of hydrogen available at the catalyst surface, this favoring the combination of nitrogen-containing intermediate molecules to promote the formation of N2 instead of being deeply hydrogenated into NH4+. Several activated carbon-supported Pt-In catalysts, activated under different calcination and reduction temperatures, have been also evaluated in nitrite reduction. The catalyst calcined and reduced at 400°C showed the best performance considering both the activity and the selectivity to nitrogen. This enhanced selectivity is ascribed to the formation of Pt-In alloy. The electronic properties of Pt change upon alloy formation, as it is demonstrated by XPS.This work was financially supported by Base-UIDB/50020/2020 and Programmatic-UIDP/50020/2020 Funding of LSRE-LCM, funded by natiunal funds through FCT/MCTES (PIDDAC). Financial support from Ministerio de Ciencia e Innovación (Spain, Project PID 2019-108453GB-C21 and PID 2020-116998RB-I00) is gratefully acknowledged

Prevalence of smoking and incidence of initiation in the Latin American adult population: the PLATINO study

Background: the PLATINO project was launched in 2002 in order to study the prevalence of chronic obstructive pulmonary disease (COPD) in Latin America. Because smoking is the main risk factor for COPD, detailed data on it were obtained. the aim of this paper was to evaluate the prevalence of smoking and incidence of initiation among middle-aged and older adults (40 years or older). Special emphasis was given to the association between smoking and schooling.Methods: PLATINO is a multicenter study comprising five cross-sectional population-based surveys of approximately 1,000 individuals per site in São Paulo (Brazil), Santiago (Chile), Mexico City (Mexico), Montevideo (Uruguay) and Caracas (Venezuela). the outcome variable was smoking status (never, former or current). Current smokers were those who reported to smoke within the previous 30 days. Former smokers were those who reported to quit smoking more than 30 days before the survey. Using information on year of birth and age of smoking onset and quitting, a retrospective cohort analysis was carried out. Smoking prevalence at each period was defined as the number of subjects who started to smoke during the period plus those who were already smokers at the beginning of the period, divided by the total number of subjects. Incidence of smoking initiation was calculated as the number of subjects who started to smoke during the period divided by the number of non-smokers at its beginning. the independent variables included were sex, age and schooling.Results: Non-response rates ranged from 11.1% to 26.8%. the prevalence of smoking ranged from 23.9% (95% CI 21.3; 26.6) in São Paulo to 38.5% (95% CI 35.7; 41.2) in Santiago. Males and middle-aged adults were more likely to smoke in all sites. After adjustment for age, schooling was not associated with smoking. Using retrospective cohort analysis, it was possible to detect that the highest prevalence of smoking is found between 20-29 years, while the highest incidence is found between 10-19 years. Age of smoking onset tended to decline over time among females.Conclusion: the prevalence of smoking varied considerably across sites, but was lower among countries with national anti-smoking campaigns.Univ Fed Pelotas, Pelotas, BrazilUniv Republica, Montevideo, UruguayInst Nacl Enfermedades Resp, Mexico City, DF, MexicoUniversidade Federal de São Paulo, São Paulo, BrazilPontificia Univ Catolica Chile, Santiago, ChileCent Univ Venezuela, Caracas, VenezuelaUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Molecular and Antigenic Characterization of the Leishmania (Viannia) panamensis Kinetoplastid Membrane Protein-11

The kinetoplastid membrane protein 11 (KMP-11) has been recently described in Leishmania (Leishmania) donovani as a major component of the promastigote membrane. Two oligonucleotide primers were synthesized to PCR-amplify the entire coding region of New World Leishmania species. The Leishmania (Viannia) panamensis amplification product was cloned, sequenced and the putative amino acid sequence determined. A remarkably high degree of sequence homology was observed with the corresponding molecule of L. (L) donovani and L. (L) infantum (97% and 96%, respectively). Southern blot analysis showed that the KMP-11 locus is conformed by three copies of the gene. The L. (V) panamensis ORF was subsequently cloned in a high expression vector and the recombinant protein was induced and purified from Escherichia coli cultures. Immunoblot analysis showed that 80%, 77% and 100% sera from cutaneous, mucocutaneous and visceral leishmaniasis patients, respectively, recognized the recombinant KMP-11 protein. In a similar assay, 86% of asymptomatic Leishmania-infected individuals showed IgG antibodies against the rKMP-11. We propose that KMP-11 could be used as a serologic marker for infection and disease caused by Leishmania in America

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

<p>Abstract</p> <p>Background</p> <p>Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.</p> <p>Methods</p> <p>This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.</p> <p>Discussion</p> <p>The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.</p> <p>Trial Registration</p> <p>Clinical Trials <a href="http://www.clinicaltrials.gov/ct2/show/NCT00970931">NCT00970931</a>.</p